Another piece of the Affordable Care Act -- the federal government's ability to subsidize the purchase of insurance through tax credits -- has now been called into question, following another round of split judicial rulings Tuesday.
"In a 2-1 ruling, the U.S. Court of Appeals for the D.C. Circuit concluded the Obama administration stretched the law too far in extending the subsidies through the HealthCare.gov website," according to the AP, meaning that subsidies are only permissible in state-run exchanges and not in those 36 states that use the federal exchange.
That decision hinges on this line in the law: that subsidies be allowed “through an exchange established by the state.”
Meanwhile, the 4th Circuit Court of Appeals unanimously upheld the ACA under an almost identical challenge, arguing that the wording error was a technicality that is not consistent either with the ACA's larger statutory goal as law or even with other passages within it.
These cases will continue working through the appeals system and may end at the Supreme Court. One thing is certain: if subsidies for the federal exchanges are tossed out, insurance premiums for people who receive such subsidies will go up. According to a new study, they could go up a lot.
"A new analysis from Avalere Health finds that without action from the federal government nearly 5 million Americans would receive an average premium increase of 76 percent," the report begins. "... In the 36 states served by the federally facilitated exchange, on average, 87 percent of individuals who bought coverage received premium subsidies."
These subsidies reduce premiums on average 76 percent, according to Avalere.
(One of the defendants who brought one of the two lawsuits, David Klemencic, argued that he did not wish to purchase health insurance at all; and were it not for the federal subsidies provided to his home state of West Virginia, the premiums would be too expensive for his annual income of $20,000 and he could opt out of the law without a penalty.)
According to a handy map, Georgia is one of five states that sees its premiums reduced the most from subsidy. Without those subsidies, premiums could increase by 80-95 percent.
Alabama's premiums without subsidy could rise 75-79 percent or higher.
Download Avalere's full report here.